There are high levels of alcohol in the UK population, with a particularly damaging pattern of ‘binge drinking’. Extreme alcohol use remains embedded in university culture. Since COVID and lockdown, male students, postgraduates and academic staff are likely to have increased their alcohol consumption. Starting university marks a rise in alcohol intake, to reduce social anxiety and ‘belong’ to the prevailing culture. High risk sexual behaviours rise significantly when alcohol is taken. Death by suicide, and deliberate self-harming, are associated with alcohol use. This is an important modifiable risk factor in addressing sexual violence and suicide. Mental disorders are strongly associated in complex interactions with alcohol use. Heavy alcohol use may be associated with other substance misuse and addictive behaviours. Abstaining from alcohol may result in striking improvements in mental health and academic performance. The rights and wellbeing of non-drinkers need to be acknowledged too. Information campaigns and paying lip service to disapproval do not work. The student age group tends to be less risk-averse than older groups. It falls to university authorities in partnership with local communities to control high risk alcohol intake.